Articles: emergency-services.
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To assess patients' comprehension of their emergency department discharge instructions and to determine if inner-city patients' literacy levels are adequate to comprehend written discharge instructions. ⋯ Overall comprehension rates in this population were good despite the fact that ED instruction sheets were written at an inappropriately high reading level. Verbal instructions given by the discharging physician likely have a significant effect on patients' comprehension of instructions.
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A new "episode of care" definition of emergency care was developed, consisting of the emergency department encounter and all subsequent, related care delivered within 48 hrs from the initial contact. Data were analyzed by ICD-9-CM Major Diagnostic Category (MDC) and surgical intervention using 1.6 million episodes generated by 809,145 separate patients from a national claims database. ⋯ For several MDCs, hospitalization and/or surgical procedures were also major determinants of overall episodic charges. Results support the premise that economic analysis and reimbursement of emergency care benefits from the use of episodic data.
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To assess the effectiveness of a specific, targeted clinical policy regarding the evaluation of nontraumatic chest pain in the emergency department (ED) to modify physician evaluation and management. ⋯ We conclude that the dissemination of the ACEP chest pain clinical policy has not significantly modified the behavior of our metropolitan area emergency physicians regarding the evaluation and management of patients who present to the ED with a chief complaint of nontraumatic chest pain.
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Health Care Manage Rev · Jan 1995
The effect of urgency on patient satisfaction and future emergency department choice.
Satisfaction with various aspects of a hospital visit may affect a patient's decisions about future patronage. Relationships between aspects of satisfaction, future use, and referral intentions, moderated by urgency, are explored in this study of 493 privately insured individuals. Results confirm the strong association between satisfaction and future intentions already established for other medical services and support increased attention to interactive marketing in medical settings.
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This study's objectives were to determine the cost-effectiveness of introducing a transcription service into an emergency department (ED) and to determine the capacity of such a service to improve physician satisfaction. A prospective study of full-time emergency physicians was conducted in the ED of a community hospital in which a transcription service was introduced during peak periods of demand. Measurement was defined from a time-and-motion study consisting of direct observation by an industrial engineer who measured documentation time required for written and dictated charts. ⋯ When the records were transcribed, the mean subjective scores for satisfaction with the medical record improved from 2.1 to 3.6 (P = .0025) on a scale of 1 to 4. Surveys of nonemergency staff physicians documented that legibility score improved from 2.6 to 3.1 (P = .0056) and completeness improved from 2.6 to 3.0 (P = .0157), both on a scale of 1 to 4. It was concluded that dictating and transcribing ED medical records decreases the time required for documentation, improves record legibility and quality, allows more patients to be seen per physician-hour, and improves the satisfaction of emergency and nonemergency physicians.